Harm reduction strategies inconsistently applied among New York drug users

Drug users in New York City are increasingly familiar with the harm reduction strategies that can lower the risk of fatal overdose, but numerous factors impede consistent use of these methods, a newly published study suggests.

In-depth interviews with 55 people at syringe exchange programs in the city found, for example, that while the majority reported carrying naloxone with them at least half the time, some individuals experienced barriers such as homeless shelter policies that prohibit carrying certain forms of naloxone.

Study results are published in the October issue of the International Journal of Drug Policy. The research, conducted at the New York University Meyers College of Nursing and College of Global Public Health, was supported by the National Institute on Drug Abuse (NIDA).

“Using methods to reduce the risk of overdose was often complicated by structural factors such as stigma, poverty and homelessness, which were further complicated by dependence and the increased prevalence of fentanyl,” said lead author Courtney McKnight, DrPH, clinical assistant professor at the College of Global Public Health.

The interviewed users reported that their most common behavior change they have adopted in response to an increasingly deadly drug supply is doing a test shot, or injecting a small amount of the drug to gauge its strength. Some participants have used fentanyl test strips, but their distribution in the city has been limited to this point.

A study co-author suggested that establishment of supervised injection sites in the city could help address some of the obstacles to preventing overdose deaths.